Analysis & Opinion

NEW YORK (Reuters Health) - As the U.S. economy began to tank, the number of abused kids landing in the hospital with severe brain injuries spiked, a new study shows.

Anecdotes linking child abuse to the recession have surfaced before, but there had been no hard data to back the connection until now.

"It's definitely disturbing," said Elizabeth Gershoff, a psychologist who studies parenting, but was not involved in the study.

Although there is no proof that financial hardship itself is causing the uptick in abuse, earlier research has tied parental stress to child maltreatment.

"Living in poverty for parents can be very stressful," Gershoff, of the University of Texas at Austin, told Reuters Health. "And that in turn leads to harsher parenting."

The new findings, released on Monday in the journal Pediatrics, are based on hospital data on kids under five from Kentucky, Ohio, Pennsylvania and Washington.

From 2004 to 2009, there were 422 children diagnosed with what doctors call "abusive head trauma." The majority ended up in the intensive care unit, and 16 percent died of their injuries.

The children's average age was nine months.

In the three years leading up to the crash in December 2007, the rate of abusive head injuries was 8.9 per year per 100,000 kids. After the crash, the number jumped to 14.7 per 100,000.

"If what we are seeing is even close to generalizable, that is a lot of excess children," said Dr. Rachel P. Berger, a child abuse expert at Children's Hospital of Pittsburgh who co-authored the study.

She said she noticed a sharp uptick in the number of children who came to her hospital with banged-up heads in 2008. From 17 cases per year, it suddenly jumped to 37 in 2008, and 11 of those kids died -- more than had been killed after accidental head traumas.

"At any given time there was virtually always a baby in our ICU," Berger told Reuters Health.

In the U.S., some 1,800 toddlers come to the hospital with abusive head trauma every year, corresponding to about one in 3,300. But that statistic is certain to leave out many cases.

"Most people really think it is a tremendous underestimate," Berger said.

Contrary to the new results, federal data show a decline in child abuse in 2008. But Berger said those numbers have many limitations, such as a very restrictive definition of abuse.

REASONS UNCLEAR

It's unclear how to account for the findings. But Berger that fewer resources might have forced mothers to leave their babies with people who don't usually take care of them -- like fathers or male caretakers.

"The number one perpetrators are fathers and male caretakers," she said. "Very few perpetrators are mothers. It's the people that mothers give their kids to that end up being the perpetrator."

Gershoff said the young age of the victims suggests crying might have caused the abuse. If a caretaker shakes a baby violently to make him or her stop crying, that may lead to "shaken baby syndrome," in which the brain bumps up against the skull it causes brain damage and bleeding.

She said babies only cry for five reasons: Because they are hungry, tired, bored, in pain or need a fresh diaper. If none of that helps, Gershoff added, it's alright to leave the crib as long as the baby is safe.

"Just taking a break from that sound, walk out and then come back when you have calmed down," she advised.

Meanwhile, Berger said, the government is not doing much to help disadvantaged parents cope with financial hardship.

"We have actually increased their stress by decreasing programs to help infants and young children," she said, adding that there have been cuts in daycare and child benefits.

"When people are stressed in this country, for instance during a hurricane, as a society we provide help to those people. Here we have an economic recession and what happens during that time is we actually pull back," she said. "We need to really think about what the outcome is going to be when we cut programs that help infants and young children."

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